A prospective multicenter comparison trial of Home Monitoring against regular follow-up in madit ii patients: Additional visits and cost impact

The number of patients with primary prophylactic ICD implantation rises. Resources for a regular ICD follow- up every 3 months are not available. The REFORM Study investigated in a prospective, randomized and multicenter comparison study the effect of ICD home monitoring (HM) against conventional follow-up (FU) in MADIT II patients: A special focus was on different resource use and resulting costs in the two different arms. For cost measurements a model from Leipzig Graduate School of Management (HHL) was used and process times and resulting costs for human resources and equipment was calculated for the study for 115 patients. The study revealed no significant difference in hospitalisations and mortality, whilst potential cost savings and reduction of patient visits at higher effectiveness was highly significant: For a group of 100 patients a sum of 81 physician hours and 71.231 euro costs could have been saved p. a. by HM in the hospital.